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1 Proposal 1 Cover letter I. M. Writer 520 Safe Drive St. Anytown, Anystate, USA (555) October 13, 2004 Mr. David Decider Director, Policy Branch Department of Highways 759 Main Rd. E. Suite 100 Anytown, Anystate, USA Dear Mr. Decider: States purpose; describes situation that gave rise to proposal Defines scope of proposed study Encourages reader acceptance and follow-up I am pleased to submit my proposal to study the problem of cyclist head injuries in our state. The economic and personal cost of these injuries is enormous. I believe I can provide the Department of Highways with a thorough and wellthought-out analysis of the problem and present viable solutions to reduce cyclist head injuries. I propose to study solutions to the problem of cyclist head injuries based on statistical and medical research concerning head injuries. Thank you for considering this proposal. Please do not hesitate to contact me if you have any questions. Sincerely, I. M. Writer encl.

3 Table of Contents Offers easy access to contents Executive Summary 1 An Overview of This Proposal 1 Cycling Head Injuries Are a Severe Problem 1 Some Real-Life Examples of the Problem 2 A Problem for Many 3 What the Study Will Do 4 Possible Solutions to Investigate 5 Action Plan 5 Budget 6 References 7

4 Summarizes basics of proposal, including cost Executive Summary Bicycle accidents occur far too frequently in our state, often resulting in permanent injury or even death. Head injuries are the most serious type of injury for cyclists, whether they are killed or just injured. These injuries are expensive both in terms of money and more importantly in terms of human suffering. I propose to study the problem by researching accident statistics and medical journals, interviewing cyclists and cycling organizations, reviewing coroners records and records of organizations involved in vehicular accidents. I will determine what factors contribute to cyclist head injuries and what can be done to reduce the severity or number of head injuries. I will explore possible solutions to this problem and analyze their merits. I can accomplish this study and present the results for $600. The benefits of reducing head injuries are fewer injuries and fatalities, less human suffering, reduced medical and insurance costs, and a reduction of the indirect costs in lost time and lost productivity. Summarizes the problem States writer s qualifications Summarizes plan for study Justifies need for study by describing problem in detail An Overview of This Proposal Thousands of our state s residents are injured or killed each year in bicycle accidents [1, 2]. Those people lucky enough to survive often suffer from serious head injuries. Besides the personal suffering of the injured cyclists and their families, these injuries place a large economic burden on our state s hospital care system. I have over six years research experience focused largely on literature and electronic information searches. As a member of a local bicycling organization and a bicycling commuter, I am aware of the issues facing bicyclists. I propose to research why bicyclists are injured. I will then analyze how to reduce the number or severity of head injuries. Cycling Head Injuries Are a Severe Problem Each year more than 10,000 state-resident cyclists are injured or killed in traffic accidents [2]. Head injuries are the most commonly reported serious injury, making up approximately 32% of reported serious injuries [3]. Each year nearly 90 residents die in this and neighboring states in bicycle-related accidents (see Figure 1), and 75% of these deaths are due to head injuries [3]. Approximately 1

5 20% of those people who survive the accident incur permanent brain damage. Serious injuries such as head injuries can be expensive to treat. The average one costs over $400,000 in medical costs, related costs, and lost time and productivity [4]. Brain injuries, for example, cost over $1,000 per day to treat, and over $200,000 per year in extended care costs [5]. The lost potential when a young cyclist is seriously brain damaged or killed is incalculable. 90 Offers visual support Deaths State A State B State C State D State E State F State G State H State I State J State K State L Figure 1: Cycling deaths by year. Source: Federal Highway Safety Commission, Presents convincing examples in form of case studies Some Real-Life Examples of the Problem To illustrate the problem of head injuries, here are some case reports from the Hub County coroner s office [6]: Case #1. A man in his mid-sixties was riding his bike on the shoulder of the East Ridge Highway near Far Hills Avenue (a controlled intersection) heading toward Anytown; he turned on to the slow lane of traffic without signaling, causing the van in that lane to brake abruptly to avoid hitting him. The cyclist then continued over to the fast lane and was struck from behind by another vehicle. Road and weather conditions were excellent. The cyclist died of massive injuries, in particular, head injuries. He was not wearing a helmet. 2

6 Case #2. The death resulting from this cyclist/motorist collision involved a 4-year-old girl riding her bike into a T intersection when a motorist, observing her approach, nevertheless, thinking he had time, turned in front of her and she ran into the right front of this vehicle. There were no mechanical or environmental factors affecting this accident. The little girl had just recently learned to ride without training wheels and was practicing stops and starts. She died immediately of massive head injuries. Case #3. A 12-year-old boy was riding his bike on the shoulder of the Lamont Highway against traffic in the late afternoon of a mid-january day. It was already dark. A truck pulled over onto that shoulder of the road to pass a vehicle turning left and struck the cyclist. The bike was not equipped with a light or reflector on the front. The cyclist was not wearing a helmet. The youth suffered multiple traumatic injuries, the most severe being head injuries. Death was instantaneous. Summarizes need for study Describes anticipated benefits of study A Problem for Many Head injuries due to bicycle accidents are a serious problem not only for the injured person. The families of the injured people experience both economic and psychological stress. Medical staff in hospitals must deal with the hundreds of traumatic injuries and deaths each year. The automobile and medical insurance system must bear the burden of the costs of these injuries. Society bears the cost of losing years of productivity from these individuals, who are typically active young people or children with their entire lives in front of them. Reducing the number or the severity of serious head injuries due to bicycle accidents will certainly benefit all these groups. Clearly, the primary benefit would be fewer needless injuries and deaths in our state. All residents would benefit from reducing the cost of these injuries in terms of the direct medical costs, the insurance costs, and the lost time and productivity. In , the value of lost time and productivity due to serious or catastrophic bicycle accidents was approximately $31 million. On top of that, the direct medical costs and related expenses added another $4.6 million [6]. A study of cyclist head injuries would help find solutions to reducing the number and severity of these injuries. A reduction in bicycle-related head injuries will quickly show up in hospital admission records, which one could monitor on a 3

7 monthly or semiyearly basis. Furthermore, several organizations including the Federal Bureau of Statistics, our state s Department of Highways, and insurance companies maintain accident statistics, which would reveal a reduction in the number of bicycle-related injuries and deaths. Details what the study will examine What the Study Will Do I will research several aspects of this problem by examining medical, statistical, and Internet-based information combined with interviews with local cyclists and cycling organizations. Specifically, I will address the following questions: 1. What factors affect mortality and injury severity of those involved in bicycle accidents? 2. What are the factors affecting the severity of head injury in bicycle accidents? 3. What changes will reduce the incidence and/or severity of head injuries? Given the head injury statistics, others proposing to study this problem may jump to the conclusion that mandatory helmet laws are the solution. I do not think one should jump to any conclusions without having studied the full extent of the problem. I plan to examine what factors contribute to bicycle accidents and what factors result in head injury. I will then examine how head injuries can be reduced both by reducing accidents in general and by finding ways to reduce the number and severity of head injuries that result from those accidents. One may object to this proposal since only 18 people in our state die each year, and only 75% of these deaths are due to head injuries. Indeed these numbers are not large. However, these figures do not take into account the number of head injuries not resulting in death. Nor do these figures really reflect the true cost of head injuries. The average serious head injury costs over $400,000 in medical costs, related costs, and lost time and productivity [6]. On top of these costs, there is a huge emotional cost for the families of those injured or killed. 4

8 Defines scope of study Possible Solutions to Investigate 1. Bicycle helmets Laws, compliance with laws Education about helmets Design of helmets Free helmets 2. Restrict bicycles from busy routes or at dangerous times 3. More bike routes and lanes 4. Driver and cyclist education 5. Increased or cheaper public transit Provides detailed plan and progress to date Describes forthcoming phases of plan Action Plan What Has Been Done So Far I have spoken to a representative of the Federal Department of Highways and obtained national fatality statistics. I have spoken with a representative of our state s Office of Statistics and obtained fatality statistics. I have done extensive searching of Web-based literature to determine the extent of the problem. What I Will Do (See Figure 2 for the Time Line I Will Follow) Researching solutions to the problem of cyclist head injuries will take place in four stages: (1) Literature Review I will review paper and Internet-based literature, including medical and statistical literature, to explore methods of reducing the number and severity of head injuries. I will examine records in an international cycling accident database on the Internet to determine factors in cycling accidents. I will study recent papers on cycling accidents and head injuries including: a. the state s Chief Coroner s 1999 Report on Deaths of Cyclists b. Dr. Jean Farsight s 2001 report, The Effectiveness of Bicycle Helmets: A Review. I will study state collision statistics to profile cycling accidents and explore solutions to the problem. 5

9 (2) Interviews I will consult with local cycling organizations to explore possible solutions to the problem. I will interview cyclists to profile local cycling safety concerns. (3) Expert Consultations I will contact auto insurance companies and similar safety organizations to explore aspects of this problem nationally and in neighboring states. I will contact the Motor Vehicles Branch in Anystate and similar organizations in other states to explore aspects of this problem. Provides timetable for each phase of study Action Local public library research: statistical information Gridley University Library: medical and statistical information Internet research: statistical information, research possible solutions Cyclist interviews State Safety Council and similar associations in other states Department of Motor Vehicles and similar associations in other states Department of Highways Local cycling organizations: Greater Hub City Cycling Coalition and Harbor Wheelers Gather and analyze collected information. Analyze possible solutions. Write final report. Projected Completion Date Oct. 16 Oct. 21 Oct. 25 Oct. 31 Oct. 31 Oct. 31 Oct. 31 Oct. 31 Nov. 15 Provides detailed budget Budget Internet service Long-distance telephone calls Car and gasoline expenses Requests for information Printing and computer equipment Miscellaneous expenses Total $50 $100 $100 $100 $200 $50 $600 I believe this to be an extraordinarily good value for helping reduce the enormous cost of head injuries due to bicycle accidents each year. 6

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